The Basic Needs of a Woman in Labour

In the True Midwifery Learning spaces, we hold at the centre of our learning The Basic Needs of the Pregnant, Labouring and Birthing Mother and her Unborn and Newborn Child.

This is foundational to this work - no matter where or in what capacity you are holding space for birth.

The Basic Needs of a Woman in Labour are:

• To feel safe
• To leave the thinking brain (the neo-cortex) switched off
• Silence
• Darkness or low lighting
• Warmth
• Not feeling observed
• No adrenaline

Safety - A sense of security

The labouring woman needs to feel secure and safe. Mammals will find a secure place to give birth. A wonderful example is female elephants who will form a circle around the labouring mother elephant with their backs turned to her.

If a labouring mammal feels threatened her labour will stop until she is in a safe place again. Human beings are not that different physiologically. We also are mammals after all. While many women choose to give birth in hospitals because they feel it is their safest option, they may find that when they arrive at the hospital their bodies react in a way which tells us that they are not feeling safe in that environment. The bright lights, the talking, the signing of papers, the questions, having to interact with strangers, the ticking clock, the cold sterile rooms, the high beds, the lack of privacy, the fetal heart monitors…these can all contribute to a feeling of being unsafe. This may make it difficult for oxytocin, the shy hormone, to make its appearance. One can then anticipate longer and more difficult labour.

How do other mammals prepare for birth?

They will find a quiet, dark place, far away from anyone, somewhere where they will feel safe and secure and know that they will be undisturbed.

A woman at the end of her pregnancy is much the same. We joke about the ‘nesting instinct’ when a woman at the end of her pregnancy frantically cleans her home in preparation for the birth. Some women cannot rest until the curtains are hung just right or the floors are scrubbed or all her affairs are put to rest. Doing this makes it possible for them to feel ready to have their baby

The thinking brain needs to switch off

One of the prime ingredients for shy oxytocin to take effect is that the thinking brain needs to switch off. We need to make sure that the labouring woman’s thinking brain (called the neo-cortex) is not stimulated.

We stimulate the neocortex during labour by talking to the labouring woman about logical things, such as telling her how many centimeters dilated she is, or asking her to remember when her waters broke. We stimulate her neo-cortex with these observations and questions, and as a result, we slow down her release of oxytocin.

A woman needs to be able to slowly fall into her labour (like falling asleep) and not be ‘woken up' by the outside world. If she can be given the space to switch off her neo-cortex, oxytocin will be able to do its job.

No observers

Feeling observed also stimulates the neocortex, so it is important that the mother does not feel watched. Observers and unnecessary people make the mother feel observed. Cameras can also slow labour down because they can make a mother feel observed which will “wake her up.”

Darkness

It is important that there are no bright lights around a labouring woman. Drawn curtains, candles and other dim lighting will help to suppress the thinking brain and aid in the stimulation of oxytocin.

Warmth

The labouring woman needs to be warm. A fire or a heater or warm water is helpful in relaxing her body and her neo-cortex. In fact, immersing herself in warm water at the right time (when she is in established active labour) can relax the mother so much that her cervix will dilate completely.

Oxytocin/adrenaline antagonism

Adrenaline prevents oxytocin from being released. Adrenaline is the hormone we produce when we are frightened, anxious, stressed or cold. It is known as the ‘fight or fright’ hormone. Adrenaline suppresses oxytocin. It can completely stop labour or make the labour longer and more painful.

Anyone who is present at a birth needs to be very aware of his or her levels of adrenaline. This is because adrenaline is contagious, which means that if you are feeling anxious or scared or nervous, everyone else in the room will soon start feeling that way too. If you are at a birth and you are feeling tense or nervous or scared, try to calm yourself down. If you can’t, it will serve the mother better if you leave the room until you are feeling better.

Have a look around and see how the other people in the room are behaving. If you can see that someone is feeling uncomfortable, you can gently let that person know that it is okay for him or her to take a break and perhaps leave the room, go for a walk, or try to have asleep. This must be done in a gentle and non-aggressive way because if you get angry or make someone else angry you will create more adrenaline.

Sometimes people are relieved to be told that they can take a break from the birth. Birth is a very intense experience, which can be very overwhelming.